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General NPI Number Information
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NPI Number | 1790574937
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW CLINICAL COUNSELING
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1830 JUDY LN
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City | DEKALB
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State | IL
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Zip | 60115-1804
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Country | US
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Telephone | 331-642-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 JUDY LN
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City | DEKALB
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State | IL
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Zip | 60115-1804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCPC
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Name | MS. KATHERINE BLUM
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Credential | MA
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Telephone | 331-642-4220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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